travel nurses make too much

Rural hospitals losing hundreds of staff to high-paid traveling nurse jobs

Some 60 million people across the country's rural areas rely on small local hospitals for medical care. But as the delta variant rages on, the hospitals that provided a lifeline to these communities now find themselves drained of the resources that sustained them: nurses.

A boom in demand for travel nurses, who work short stints at hospitals around the country to fill high-demand positions, has exacerbated a longtime staffing issue, with rural nurses enticed away by salaries that can be almost 10 times what they made in their hometown.

Nurses at rural hospitals are paid an average of $70,000 a year or just over $1,200 a week, according to hiring website ZipRecruiter. But some staffing agencies such as Nomad Health are offering travel nurse positions with a $5,044 a week salary. White Glove Placement, another nursing staffing agency, offers placements that pay anywhere between $5,800 and $5,900 a week. Health care hiring site Vivian lists several travel nurse assignments that pay up to $9,562 a week.

Covid was uniquely suited to take advantage of every fracture in the rural hospital workforce and widen it significantly.

"If you lose one or two nurses, that makes a difference," said Audrey Snyder, president of the advocacy group Rural Nurse Organization and a faculty member at the University of North Carolina Greensboro School of Nursing. “These hospitals are small hospitals and they don't have a large nurse workforce.”

Years of low patient volume, a high number of uninsured patients, along with government-funded insurance payers, led to a record number of rural hospital closures last year, according to the Cecil G. Sheps Center for Health Services Research.

Dozens of rural hospitals filed for bankruptcy last year, including Eastern Niagara Hospital in Lockport, New York, Faith Community Health System in Jacksboro, Texas, and Pinnacle Healthcare System hospitals in Kansas and Missouri. Another 216 rural hospitals are currently at high risk of closure, said Brock Slabach, chief operations officer with National Rural Health Association.

“The rural hospital workforce has always been a challenge,” Slabach said. “What Covid was uniquely suited to do was take advantage of every fracture and widen it significantly and make it even harder to cope with demands being placed on them.”

Most of the demand is not even directly related to Covid patients, said Susan Salka, CEO of AMN Healthcare Services Inc., on an earnings call last month. Rather, it is "leaves of absence, clinician fatigue, normal patient volumes rising and operating room backlog. Our clients are telling us that this is unlikely to change anytime soon,” she said.

While the surge in popularity of travel nursing has deepened the country’s nursing shortage, it has been a boon for staffing agencies. AMN Healthcare Services Inc., a San Diego-based medical staffing agency, reported a 41 percent increase in revenue from the same time last year. Its travel nurse staffing business alone grew by 37 percent, it reported.

Cross Country Healthcare CEO Kevin Clark told investors in an earnings call last month that travel nurse orders across the staffing agency’s clients increased by nearly 50 percent over the course of the second quarter. Revenue for its travel nurse business rose by 58 percent, he said.

“We are coming out of the pandemic with, I think, flying colors,” he said. “First time travelers are up significantly this year. That trend continued through the second quarter.”

Many nurses are turning to travel nursing in large part because of pay, but also the opportunity to hone their skills and advance their careers, said Nicole Rouhana, director of the graduate nursing program at the Decker School of Nursing at Binghamton University. Nurses in rural areas are considered jacks of all trades, she said. One night they could be working the emergency room and another night they could be assisting with a birth.

“[Travel nursing] is more popular right now and I think it’s partially because we're also a mobile society and there is some attractiveness in going to Southern California and working six weeks and going to the northeast and working in the summer,” she said.

Rouhana, along with other nursing programs and clinics, have rolled out new fellowships and short-term educational experiences for nurses to learn new skills in a rural hospital setting, in hopes that they continue to serve the community. Some state programs will forgive college debt for nurses who spend a certain number of years working in rural hospitals. At the same time, health care companies are offering bonuses. Unity Health in Newport, Arkansas, increased its signing bonus to $15,000 for new bedside nurses. Monument Health in Rapid City, Iowa, is offering experienced nurses up to $40,000, in order to fill several ICU and operating room nurse positions.

But smaller rural hospitals cannot afford to pay nurses a competitive salary, said Shannon Cannon, a professor with Texas Tech University School of Nursing. The counties where rural hospitals are located sometimes have only a couple of thousand residents, which means taxes are lower, she said.

“If you live in a community in rural west Texas with 1,500 to 2,000 people, trying to find a nurse still within that community is hard,” she said. “They get lured away to go to larger cities because the pay is better and there are more attractions, especially for young nurses.”

Patricia Gonzales Meserole, 50, has worked in healthcare in the rural city of Washington, Iowa for over 8 years, currently making about $30 an hour as a nurse. She says she’s been spoiled by the quiet and small town culture of the town. But now she’s on the hunt for a travel nurse position that will give her the hospital experience she craves from a well-resourced institution and provide the salary she needs to stabilize her finances.

“It hurts my heart to tell my boss she’s going to have to replace me, because its hard to find people right now,” she said. “But this is my opportunity to use those skills and make this level of money. My goal is to pay off debt and loans and build a future, because I can’t do that right now.”

Leticia Miranda is a business reporter for NBC News.

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The Future of Work Issue

‘Nurses Have Finally Learned What They’re Worth’

As the coronavirus spread, demand for nurses came from every corner. Some jobs for travelers paid more than $10,000 a week. Will the boom last?

Chris Detten earned enough as a traveling nurse to make a down payment on a home in Lubbock, Texas. Credit... George Etheredge for The New York Times

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By Lauren Hilgers

• Published Feb. 15, 2022 Updated June 15, 2023

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In the early morning on Mother’s Day in 2020, Solomon Barraza walked into an intensive-care unit in Amarillo, Texas, and, with the fluorescent lights clicking on above him after the night shift, flipped through the stack of papers attached to a gray clipboard — his roster of patients and nurses for the day. Barraza, who was 30 at the time, had only recently become a charge nurse at Northwest Texas Healthcare System hospital. He was technically still a “baby nurse”: Just over a year earlier, he started working his first shifts in the I.C.U. Now he was responsible for overseeing the care of everyone there, making sure his nurses and patients had whatever they needed, answering questions and directing care in case of an emergency. As he looked through his roster, he saw that there were 11 patients on his floor; eight had Covid-19, and five of those were intubated. Then he looked at the other sheet of paper. There would be four nurses working for the next 12 hours. He needed at least six.

He could see the day play out: a cascade of emergencies, a cacophony of beeping alarms and running feet, disasters that ended with overwhelmed nurses and patients crashing alone. And so for the first time, Barraza made the decision to call for “safe harbor” under a Texas law that can be invoked to protect nurses’ licenses while working in conditions that are potentially unsafe for patients. Barraza grabbed a form from the nurses’ station, and one by one, they all signed it.

Almost immediately, the emergencies began. “You need to get over to 18!” someone shouted. Barraza grabbed his mask and ran. He started hand-pumping air into the patient’s lungs with a ventilation bag while two other nurses hooked the bag up to oxygen. They stabilized that patient, and Barraza jogged down the hallways to check on the other seven. One person’s blood pressure was dropping precipitously, and Barraza was preparing to go inside the room when he thought to check on another patient, one door down. That patient’s blood-oxygen level had dropped into the 40s, far below the normal range of 95 to 100. “So what do I do?” Barraza said. “Who do I help first? There are multiple people’s lives at stake at the same time. What if I pick wrong and someone dies?”

A year and a half later, Barraza was sitting on the desk in the middle of the cardiac-intensive-care unit, or C.I.C.U. — which handles both coronary and Covid patients — looking around the group of nurses, remembering those first months of an ongoing crisis. “There were some funky things going on with staffing back then,” he told the group. Nurses were leaving the hospital to take traveling jobs in New York. The rest of the hospital was shut down, so the I.C.U. floor was the chaotic heart of a ghost town. The hospital had yet to hire traveling nurses to pad its local staff, and Mother’s Day felt like a turning point. It was the day Barraza recognized that the pandemic would be defined by twin emergencies, two figures that he would watch anxiously as they rose and fell: the waves of patients on ventilators in his I.C.U., and the number of nurses available to take care of them.

In 2020 alone, Northwest lost 185 nurses — nearly 20 percent of its nursing staff. In the I.C.U., that number was closer to 80 percent. Many of those nurses left to take jobs with travel-nursing agencies, which placed them, on a temporary and highly lucrative basis, in hospitals throughout the country. When the nurses at Northwest quit, the hospital eventually hired its own travelers, who flowed onto Barraza’s floor to work for weeks or months at a time. There have been days when the unit was barely staffed and days when 20 travelers showed up unexpectedly. Barraza has watched friends burn out and retire. He has watched nurses leave for better pay or less stressful jobs. He has welcomed the strangers who have come to take their place — befriending them, folding them into his I.C.U. team and then watching them leave all over again.

Bedside nursing has always been, as one hospital chief executive put it, a “burnout profession.” The work is hard. It is physical and emotional. And hospitals have built shortages into their business model, keeping their staffs lean and their labor costs down. When the pandemic hit, shortages only increased, pushing hospitals to the breaking point. Nationwide, the tally of nurses with both the skills and the willingness to endure the punishing routines of Covid nursing — the isolation rooms, the angry families and the unceasing drumbeat of death — is dwindling. In a survey of critical-care nurses last year, 66 percent of respondents said they were considering retirement.

Sitting on the desk that day, Barraza didn’t know why he kept reflecting on May 2020. He had stabilized those two patients that morning, but that would not always be the case. For the most part, he said, the days bleed together in his mind. Sometimes it felt as if he had spent the last two years running the world’s longest marathon, his adrenaline pushing him from patient to patient, watching people die and trying his best to pause for a moment, just enough time to recognize each as an individual without being overwhelmed by emotion.

“That was the first time we called for safe harbor,” said Matt Melvyn, a veteran nurse who has stayed with Barraza throughout the pandemic. “But it was definitely not the last.”

In the flood of resignations, retirements and shortages that have redefined workplaces across industries these past two years, nothing has been as dramatic or as consequential as the shifts taking place in nursing. The scramble for bedside nurses is tied to everything from how we run our hospitals to the way we value the work of caring for others to our understanding of public health and medicine. And if our health care system has faltered under the weight of the pandemic, it will need hundreds of thousands more nurses to build itself back up.

For at least three decades, hospitals across the United States have followed a model that aims to match nurses precisely to the number of occupied beds. It’s a guessing game that has charge nurses performing daily tallies and hospital administrators anticipating the seasonal movements of illness and people — winter flus and migrating retirees. Many hospitals don’t offer nurses clear paths toward career advancement or pay increases. Depending on demand, they may trade nurses between units. When there are shortages throughout the hospital, they will send out emails and text messages asking nurses to come in and take an extra 12-hour shift. And when the shortages are too great, hospitals turn to travelers.

Even before the pandemic, there were many reasons to hire travelers. Nurses would be brought in for a season, a maternity leave or the opening of a new department. This kind of gig work grew increasingly common, and from 2009 to 2019, according to data from Staffing Industry Analysts, revenue in the travel industry tripled, reflecting a work force that was already in flux. There are hundreds of staffing agencies in the United States — national agencies, regional agencies, agencies that specialize in bringing in nurses from other countries, agencies that send American nurses abroad. In mid-March 2020, there were over 12,000 job opportunities for traveling nurses, more than twice the number in 2019.

Then, as the coronavirus spread, demand came from every corner. By December 2020, there were more than 30,000 open positions for travelers. And with the help of federal dollars — from the CARES Act Provider-Relief Funds and the American Rescue Plan — their salaries started climbing. Job listings in Fargo, N.D., advertised positions for $8,000 a week. In New York, travelers could make $10,000 or more. The average salary of a staff nurse in Texas is about $75,000; a traveler could make that in months.

Nurses often refer to their jobs as a calling — a vocation that is not, at its core, about money. At the same time, nurses have spent years protesting their long hours and nurse-to-patient ratios. In 2018 alone, there were protests in California, Michigan, New York, Pennsylvania and several other states. When the pandemic hit and travel positions opened up in hospitals all over the country, nurses suddenly had more options than ever. They could continue serving patients, continue working grueling hours in frantic conditions, but they would be paid well for it. Travelers were valued. Their work was in demand. The money would be enough that after a few weeks or months on the job, they could go home and recover.

Hospital associations were already beginning to see the steep costs of these workers, but they had little choice in the matter. The shortages were too severe, and they would only get worse. In July 2020, Texas established a statewide emergency staffing system, coordinated by select regional advisory councils. The state has put $7 billion in relief funds toward supplementing staffing, which has allowed hospitals like Northwest to attract travel nurses without shouldering the full cost. “The problem is that their salaries were so much higher than our employee salaries,” said Brian Weis, the chief medical officer at Northwest. “Our employed nurses were doing the same job, but they’re saying, ‘Why are we getting paid a fraction of what these nurses are?’”

The following year, the demand for travel nursing broke loose from Covid. In April and May 2021, as case counts dipped, hospital requests for travel nurses only grew exponentially. “They now know what pent-up demand does to a health care system, and it’s not healthy,” said April Hansen, the group president at Aya Healthcare, one of the largest providers of travel nurses in the country. “If you look at our demand today, it looks like our demand pre-Covid in terms of specialties: med surge, telemetry, I.C.U., emergency room, surgical. It’s just the volume that is being asked for in every specialty.”

It isn’t the traveling-nurse boom alone that has transformed the market. There are also more job opportunities beyond the bedside than ever. Nurse practitioners treat patients in doctors’ offices; insurance companies employ thousands of nurses; Microsoft and Amazon have hundreds of open nursing jobs. Today, only 54 percent of the country’s registered nurses work in hospitals. “There was competition for talent before the pandemic,” Hansen said. “But the pandemic took a small crack and made it as wide as the Grand Canyon.”

To make things worse, the nursing shortage is part of a worker shortfall that spans the entire health care industry. “This is labor across the hospital,” said Rose O. Sherman, an emeritus professor of nursing at Florida Atlantic University. “This is respiratory therapy. This is lab. This is dietary, environmental services. They have not been immune to having an Amazon warehouse open up and losing a significant chunk of their staff.” If labs are backed up, patients have to wait for a diagnosis. If rooms aren’t cleaned, nurses step in to do the work themselves. Barraza has been known to empty bedpans when the housekeeper is too busy.

Even as hospitals have scrambled to hire travel nurses, many have been chafing at the rising price tag. A number of states are exploring the option to cap travel-nursing pay, and the American Hospital Association is pushing for a congressional inquiry into the pricing practices of travel-nursing agencies. Sherman, however, believes that the problem will not be solved until hospitals start considering how to make bedside jobs more desirable.

After two years, nurses have borne witness to hundreds of thousands of deaths. They have found themselves in the middle of a politicized illness and faced countless angry, grieving family members. Many, now, are moving on. They are looking for jobs outside the hospital. Others are simply uprooting themselves — leaving their homes and their families and continuing to do their jobs for a higher salary. “Nurses have finally learned what they’re worth,” Nora Shadix, one I.C.U. nurse, told me. “I don’t think they’re going to go back to the way it was before. I don’t think they’re going to settle.”

One of the nurses who has cycled through Barraza’s staff is Kulule Kenea, who was furloughed from her job as a nurse practitioner in Minneapolis in March 2020 as part of the city’s initial lockdown. She spent her early years working in I.C.U.s and trauma wards. Her uncle was a registered nurse, as was her cousin. It was something she had always wanted to do. Kenea, who is 33, liked her job. She never had that itch to travel or move. Even before starting her furlough, she got text messages from travel agencies looking for nurses willing to fly to New York. She wasn’t sure how the agencies got her number, but the offers kept coming. “I saw and heard other nurses too,” she said, “just getting mass texts out of nowhere.”

Many nurses like Kenea started traveling in the early months of the pandemic. They were nurses who had also been furloughed, nurses whose personal circumstances allowed them to travel, nurses who felt the call to help people in an emergency and nurses who were drawn by the salaries. Ivette Palomeque, who lives in Texas, traveled to Florida during her divorce. Shadix, who was working at BSA Health System in Amarillo, the hospital across the street from Northwest, decided to travel for six months starting in the summer of 2020 after her boyfriend at the time gave her the number for a staffing agency. Susie Scott, a charge nurse in Abilene, Texas, left her job in the fall of 2020, after 19 years at the same hospital; it had become so short-staffed that Scott was doing the jobs of two or three people. Traveling was an escape. “Now, what I do,” Scott told me, “I go in, I take care of my patients and that is it.”

“People were so desperate for this particular skill,” Kenea told me. “My only responsibility at home is to water my plants. I don’t have kids. I don’t have any other responsibilities. It felt wrong. It felt unfair to be able to just sit at home in the comfort of my house when other people are suffering.” Kenea took a contract to travel to New York and was on an airplane within days — there were only a handful of other people on her flight. She spent a night in a hotel, woke up the next morning and boarded a bus heading to a hospital in Harlem. She was assigned to a medical surgical unit and, on her first shift, was given 11 patients, compared with the typical four or five. It was, Kenea said, unreal. “It did not feel like America.” She worked 14 days in a row, 12-hour shifts, compared with the three-day-a-week standard before the pandemic. She did chest compressions on one patient while another was in the room, watching her, terrified.

Kenea’s father sent her text messages daily, asking her to come home and to stop risking her health. “He would send me all these statistics,” she said. “And I would be like: ‘I’m in the hospital. I know.’” A few months later, in July 2020, Kenea contracted with a traveling agency called Krucial Staffing, which specializes in emergency disaster response. She knew her assignment would be in Texas but had to call in to learn which city — the agency was working primarily with nurses who were willing to go anywhere at a moment’s notice. Kenea would have about a day to get her bearings, taking quick tours of I.C.U.s, notebook in hand. The alarms in each I.C.U. have their own sounds. The charting systems change from place to place. “You need to know the pins for certain doors and a telephone number or email for a manager or somebody who can make stuff happen for you quickly,” Kenea said. “You need to get those things down pat first within the first couple of hours: eyes wide open, ears listening sharp, constantly aware of things.”

Kenea was sent to Corpus Christi and assigned to an older part of the hospital that had been reopened to help accommodate the influx of Covid patients. Not long afterward, she was transferred to another ward, where many of the nurses were younger than she was. Kenea worked a relatively manageable five days each week, although the job was still grueling. “I am not afraid of running toward the fire,” she told me. And the staff nurses were welcoming. Some stopped to ask Kenea for advice on how to start traveling themselves.

Barraza’s unit sits on the fourth floor of a tower on the north side of Northwest. It is brightly lit and wide, and most doors have a yellow sign alerting everyone to the need for personal protective equipment. The medical intensive-care unit, or M.I.C.U., where Shadix has been working as a staff nurse after her stint as a traveler, is separated from the C.I.C.U. by a bank of elevators. There, the lights are dim, and most of the patients have been medically paralyzed so the ventilators can work without resistance. Alarms beep, and monitors are facing the glass, the oxygen levels of each patient blinking toward the hallways.

I.C.U. nursing demands a particular set of skills. Nurses here monitor life-support equipment, track patients’ reactions to medications and respond quickly in an emergency. It can be physical work — it takes multiple people, for example, to turn a patient without unhooking any equipment. I.C.U. nurses are trained to titrate several medications and drips. Good nurses can anticipate when a patient is about to crash. They’re expected to handle situations that are unpredictable and patients who are unstable. “If you don’t use those skills,” Kenea said, “you lose it.”

In December 2020, Kenea arrived in Amarillo for an assignment on Barraza’s team. By that time, the hospital had already seen waves of travelers come and go. Before the pandemic, potential travel nurses were carefully vetted by agencies for expertise and good standing. They were required to have clocked at least a year in their specialty, sometimes two or three. Kenea, for her part, had eight years of nursing experience under her belt. During the early days of the pandemic, however, with hospital staffs suffering from shortages and looking for immediate relief, many local nurses and administrators had doubts about the level of experience of some of the travelers who were landing in their I.C.U.s.

When groups of travel nurses started arriving in Amarillo, Barraza barely had time to connect with them before they disappeared. Their contracts didn’t stipulate how long they needed to stay in any particular hospital, and some would be gone within weeks. Barraza worked shifts in which he was the only member of the core staff, unsure of who had the experience to handle an emergency. “There were some travelers that came, and they were amazing,” he told me. “They were some of the best nurses I’ve worked with. But then there were the ones who shouldn’t have been there.”

If the challenge for travelers, before and during the pandemic, has been to do their job in an unfamiliar environment, the challenge for the nurses who stayed was to offer consistency amid the chaos. Barraza knew early in the pandemic that he would stay. He took on the job of keeping up morale and arrived at his shifts with the energy of a favorite aunt. He started taking in baskets of candy and snacks. He knew the moods of his nurses and which patients were feeling scared and in need of company. He knew who needed a break and who could keep going.

As time went on, the work of boosting morale became more difficult as nurses found themselves facing an unprecedented level of hostility from the outside world. A majority of Covid patients now in the I.C.U. at Northwest are unvaccinated — the region hovers below a 50 percent vaccination rate — and restaurants and malls are filled with unmasked people. Melvyn, the veteran on Barraza’s team, said that one of the most difficult parts of the job is walking outside the hospital into a world where it seems that the pandemic is already over. “You are here and it’s a war zone, and you walk outside and there’s no war,” he said. “My whole life we’ve been preparing for a pandemic, but in none of those meetings, in none of those drills, did anyone say, ‘What if there’s a pandemic, and nobody believes it’s a pandemic?’”

Families of patients now yell at staff daily, asking for unproven treatments or accusing nurses of doing harm. They oppose intubation or refuse to wear masks. Shadix still remembers the time a family blamed her for the death of their loved one. “I will always have compassion for my patients,” she said. “But I’m running out of compassion for the families.”

Nurses have compassion fatigue, fatigue fatigue and alarm fatigue, becoming desensitized to the beeps of monitors. Nurses at Northwest have nightmares about crashing patients, nightmares that they’re being intubated themselves, nightmares that wake them up doing chest compressions on their mattresses. Shadix turns on cartoons while she falls asleep to drown out the soundtrack of alarms that plays in her head. A lot of nurses are stoic, she said. They hold it in. They make jokes. “Surely the Lord is going to bless me for putting up with all of this crap,” one nurse told me.

On bad days, Barraza holds the nurses’ hands while they cry. “We have a pretty well versed nurse that has been a nurse for a long time,” he told me. “But there was a day when her patient was going to be intubated, and she was in the hallway crying, saying that this isn’t fair and she couldn’t do it. I hugged her, and I said: ‘It sucks that it is this hard, but you’re here for a reason. I am here for you, and you’re here for me, and we’re here for these people.’” He went on: “I’m still trying to keep holding on to that aspect of my personality and who I am. If I start losing that part of me, then I need to get out.”

When Shadix was traveling, she left her daughter in the care of her mother and ex-husband and struggled to leave her work at work, she said. For months she took it back to her hotel rooms and Airbnbs — the faces of the patients she lost, the feeling of doing chest compressions, the fear in people’s eyes when they came in. Now when she loses someone, she counts to 10 and allows herself to feel all her emotions. Then she takes a breath and does her best to put them aside.

But for many other travelers, the exhaustion and the hostility they regularly face is blunted by their ability to do something staff nurses can’t: leave. Kenea thinks that moving around has helped her navigate the emotional toll of the pandemic without losing hope — she has witnessed death firsthand, but in episodes, each hospital providing a change of scenery. And when she “decommissions” from an assignment, she allows herself a break before she takes a new job. She feels overwhelmed at times but never burned out. At the end of each shift, she assesses her day, and if she feels she has done everything she can, she lets go of it as soon as she leaves the parking lot.

Then, of course, there’s the pay. Kenea has made enough money to help cover the tuition to become a nurse anesthetist. Shadix’s six-month stint as a traveler allowed her to put a down payment on a house. Chris Detten, a traveler at Northwest, was also able to afford a down payment. Adrian Chavira, Detten’s friend and another traveler at Northwest, said the money has made it possible for his partner to stay at home with their new baby. “Money is a very good motivator,” Detten said. There’s a sense that all the hard work is being rewarded. “You don’t have to worry about the politics of the hospital you’re in.” The power plays, the interoffice dramas, the personalities you can’t escape — the travelers are insulated from it all.

“I appreciate that they’re here,” said Karen Hammett, a longtime charge nurse at Northwest. “Am I a little salty that they’re making more than me? Yes.” Hammett was a veteran of the hospital. She had made it through every wave of the pandemic. But last year was her hardest. “It’s having to deal with the secondary stuff that gets to me — the hate is what sucks. And it’s the worst it’s ever been.” She had her last shift at Northwest on Nov. 21. After nearly 20 years at the hospital, she quit.

As I.C.U. beds in city hospitals filled up and staff nurses started leaving in droves, another story of a precariously overextended health care system was unfolding in smaller hospitals across the country. Rural hospitals, which have long sent their most acute cases to larger hospitals, were left with patients they were ill equipped to handle. Many of these hospitals, with lower profits and wages, struggled to retain nurses and compete with the enormous salaries offered by travel agencies. With no padding, entire departments shut down. Only 40 percent of rural hospitals in Texas offer labor-and-delivery services, and with staffing shortages, many deliver babies only a few days a week. There are 71 counties in the state with no hospitals at all. Across the country, 22 rural hospitals have shuttered in the past two years. According to one 2020 study, 453 more are in danger of closing.

Hereford Regional Medical Center is roughly 50 miles southwest of Amarillo. Shortly before Christmas, hospital officials there declared an internal state of disaster — all the travelers had gone home for the holidays, leaving the remaining staff and administrators struggling to keep the doors open. Administrative staff took shifts over Christmas and New Year’s to avoid a complete shutdown. Nursing teachers from Amarillo drove in to help bridge the gap between the departing and arriving traveling nurses. The hospital had stopped performing surgeries and was sending its labor-and-delivery patients to other hospitals. It could no longer take referrals — serving only the people who showed up in the emergency room — and none of the larger hospitals nearby were able to take its acute cases.

Other rural hospitals are reeling from similar shortages. In Missouri, one rural hospital was unable to transfer a patient with acute pneumonia after contacting 19 different hospitals. A nurse saved the woman’s life by staying up all night, loosening the mucus in the patient’s lungs with a hand-held massager. Rural hospitals in New Mexico have reported calling 40 or 50 hospitals in order to find a bed for acute patients. Candice Smith, the chief nursing officer at Hereford Regional, said: “We need staff, we need supplies, we need medicines. We have spent multiple hours on the phone to try to get patients out of here. If they’ve had a stroke or a heart attack or a traumatic brain injury, we’ve been getting them to Dallas or Oklahoma.” Smith sent a request to its regional advisory council asking for more travelers, but she was unsure of when, or whether, they might show up. “As a rural hospital, we can’t pay for them forever,” she told me. “It will cripple the health care industry.”

“There has been an evolution in the travelers,” Smith continued. “Now they don’t come here or to any facility and say: ‘What can I do? I’m willing to work any day you tell me to.’ Now they say: ‘I’m only going to work Sunday, Monday, Tuesday. I’m going to take off for Christmas.’” When I asked Smith if there was anything else she wanted to share, she said simply, “Just tell people to pray for us.”

In light of the grim staffing numbers, both city and rural hospitals have tried to focus on retention efforts, in some cases mirroring the benefits of the travel-nursing industry. Northwest now offers higher overtime rates for nurses who take extra shifts, and BSA started offering better pay overall. In Florida, hospitals are hiring recent nursing graduates and placing them in nursing teams with more experienced personnel. UAMS Medical Center at the University of Arkansas for Medical Sciences is offering a signing bonus of $25,000 to qualified nurses willing to stay for three years. At Parkland Health and Hospital System in Dallas, doctors have been helping ease the burden on nurses by performing some of their duties.

Ronda Crow is the chief nursing officer at Moore County Hospital District, a nonprofit that serves Dumas, Texas, and the surrounding rural areas. She has spent nearly 10 years working on hiring and retaining nurses, including implementing scholarship programs to help local students through nursing school. Everyone was paid a full salary throughout the pandemic whether they were scheduled to work or not — an incentive, Crow hoped, to stay. “We’re lucky here in Dumas,” she told me. The hospital has the backing of a foundation that helps with funding. During the pandemic, Crow has managed to increase her staff and now has the ability to open every bed in the hospital. “By staffing up, it gives me the opportunity to grow nurse leaders,” Crow said. “Is it an expensive gamble? Yes. Will it pay off in the end? Yes.”

Other rural hospitals, however, will continue to struggle. Without state support, many can’t afford to pay the higher wages that nurses are commanding. Fewer patients are insured, and many are older, their illnesses more severe. And experienced nurses are continuing to leave for other, lower-stress jobs. There are around 153,000 new nurses being licensed every year, but based on projected demand, it will not be enough.

For Barraza, each new spike in Covid patients seems to happen overnight. He may know a surge is coming. He may worry about families gathering for the holidays, but the influx always feels sudden. In the fall, Covid cases in Amarillo dropped, and the hospital was assigned fewer state-subsidized nurses. But the moment the travelers started to leave, a wave of new Covid cases began to fill the hospital’s beds. Northwest scrambled to bring in travelers again. Then the Omicron variant arrived. The hospital’s exhausted nurses went into overdrive. In late December, Shadix texted me a GIF of an exploding house.

“It’s bad,” she said. “But it’s fine. We’re fine.” There were new nurses in the medical intensive-care unit, people who had just graduated, and Shadix was watching them flounder. “It’s a sink-or-swim situation,” she said. “And you learn to swim really quickly, because otherwise, people die.” She had taken on many of the hard conversations with families — telling them that their loved ones would probably not make it. “They started calling me the hospice queen,” she said grimly. Families were allowed to enter the I.C.U.s, and Shadix let them, hoping that once they saw how bad things were — how low the quality of life was for their family members — they would start to let them go. Early in the pandemic, Shadix told me, nurses in the M.I.C.U. tried to stay positive, to offer family members a ray of hope until the end. Now they are more realistic. They need to set expectations.

By January, Northwest had made appeals to the regional advisory council and FEMA for more nurses. Covid patients were filling up the emergency room and surgical floor. At one point, Brian Weis, the chief medical officer, knew of 43 patients in rural hospitals waiting for a transfer. Around 75 staff members at Northwest were in quarantine. While travel and military nurses began arriving, core staff continued leaving. Dellani Spradling, a charge nurse in the M.I.C.U. who never anticipated leaving, abruptly resigned in early February. Another Northwest nurse took a traveling job that moved him to the hospital across the street.

Shadix hopes to be a traveler again. She loves the physicians she works with at Northwest — she knows what labs they need and what questions they’re going to ask. But staying doesn’t make sense. “Here you are, killing yourself for five days making pennies,” she said, “versus working four days or three days making three times what you’re making right now.” Once Shadix goes, some of the longest-serving nurses in the M.I.C.U. will be travelers.

Many nurses are hoping to move on from the I.C.U. entirely. Kenea is starting the nurse-anesthetist program in May. Shadix is taking classes toward her nurse practitioner’s license. “Maybe once this is all over and done with, I’ll come back to the I.C.U. and take my normal patients,” she told me. “But if I never have to see another N95 mask in my life, I will not be sad.”

Barraza is hanging on for now, providing as much continuity as he can. In December, he was working six days a week. The C.I.C.U. was so full of Covid patients that it couldn’t take transfers from the emergency room. “We have beds; we just don’t have the ability to staff them,” he told me. “If we do bring them in, we just overwhelm people even more and possibly push them out the door.”

Barraza has begun taking patients himself in addition to overseeing all the nurses in his unit. He tries to take his candy cart down to the nurses in the emergency room now — he knows they are tired, too. Emergency-department doctors are in such huge demand in smaller hospitals that Weis recalled at least one at Northwest who was contacted and told to name his price.

As the new year started, however, even Barraza was beginning to fray at the edges. He has been having trouble falling asleep. He passes out on his couch most nights. “I lay there, and I see the people that I saw all day and the people that I saw before. I try to keep myself centered and not dwell on it too long, because it puts me in a low place.” He thinks, instead, of his staff. He thinks of the nurses who have made it out. He thinks of a patient who recently recovered. He tries to relax, but sometimes his body won’t let him forget.

Lately, as he tries to fall asleep, he has been feeling the phantom pressure of a hand in his — the feeling of a patient about to be intubated, another frightened person on the edge of life and death. “You get all these sensations and feelings,” he told me. “Feeling them grasp you, and feeling their grasp letting go when the medication hits them.”

Lauren Hilgers is a writer based in New York. She is the author of “Patriot Number One: A Chinese Rebel Comes to America.” George Etheredge is a New York City based photographer raised in North Carolina. He was recognized as one of “The 30: New and Emerging Photographers to Watch in 2020.”

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Map: The pay gap between travel nurses and RNs

Although the cost of travel nurses has since dropped from its pandemic high, the pay gap between travel nurses and staff RNs remains high, with travel nurses earning roughly twice as much as RNs per week. To combat these high contract labor expenses, some hospitals are creating their own internal staffing agencies to offer nurses higher pay and flexibility while controlling costs.

The pay gap between travel nurses and RNs

Throughout the pandemic, many hospitals have had to turn to travel nurses as they struggled with both Covid-19 surges and widespread staff shortages. Compared to pre-pandemic levels, contract labor expenses are now almost 500% higher, according to a Kaufman Hall report commissioned by the American Hospital Association (AHA)—and these costs have pushed many hospitals into negative margins in 2022.

Although travel nurse pay is now much lower than its peak in late 2020, the average cost of a travel nurse is still roughly double that of a staff RN.

According to the U.S. Bureau of Labor Statistics , the average hourly pay for an RN is $39.78, or $1,591 a week. In comparison, data from Vivian Health , a national health care hiring marketplace, shows that the weekly pay for travel nurses in November was $3,204.

Across all 50 states, the pay gap between travel nurses and RNs ranged from 151% (Hawaii) to 287% (South Dakota), according to data organized by Becker's Hospital Review .

Hospitals create their own internal staffing agencies to curtail labor expenses

As hospitals continue to struggle with high labor expenses from travel nurses, some have decided to create their own internal staffing agencies to offer nurses more flexibility and higher pay while still curtailing expenses from outside agencies.

For example, Allegheny Health Network created its own in-house staffing team that works in various units within its 14 hospitals. The nurses who work for this unit have higher hourly pay than regular staff RNs and have access to full benefits. Although they move among different hospitals, they can also "sleep in their own bed," said Claire Zangerle, Allegheny's chief nurse executive.

Similarly, Jefferson Health also recently created its own internal staffing unit, which currently has 35 full-time workers. "There's a huge shift in the evolution of health care in creating more staff who can move around," said Daniel Hudson, Jefferson's VP of nursing administration and operations.

According to Kaiser Health News , hospital officials at Piedmont Healthcare , which recently formed its own hospital staffing unit, believe the unit provides the "best of both worlds—the flexibility of a staffing agency and the stability and support of a local health system."

Akin Demehin, AHA's senior director of quality and patient safety policy, said that work flexibility, including location and the frequency and structure of shifts, is likely to be a key draw for nurses going forward.

In addition, Kim Sauro, director of Henry Ford Health System 's internal staffing unit that began in 2013, said the cost of in-house staffing teams is much less than the cost of travel nurses from outside agencies.

So far, many internal staffing units remain relatively small, and they are not likely to significantly impact the travel nursing industry just yet. "Their success would very much depend on their ability to attract, recruit, and retain nurses," said Chris Eales, from Premier Healthcare Professionals . "They have to build up some credibility."

Currently, many hospitals are still hiring travel nurses, even as they fill out their internal staffing units. However, hospital officials are hopeful that internal staffing agencies will continue to grow as nurses and other workers, such as surgical techs and respiratory therapists, look for more flexible working conditions.

"I don't think we'll ever be temp agency-free," Zangerle said. But flexible internal hospital teams "are going to change the labor market." (Robertson, Becker's Hospital Review , 12/15; Miller, Kaiser Health News , 12/15)

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Posted on December 20, 2022

Updated on March 18, 2023

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Pandemic price gouging complaints raise staff tensions with traveling nurses

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Like most traveling nurses right now, Pamela McNairy of Mississippi says she’s making more money than she ever thought possible. She’s working in a Southern California COVID unit, getting $10,000 a week before taxes.

But that’s working 13-hour shifts, overnight, five nights a week. 

“We’re the ones who are actually doing the real patient care and keeping these people alive,” she said. “I’m telling you, it’s hard.”

So it doesn’t sit well with McNairy that the American Hospital Association is calling for price gouging inquiries into staffing agencies, citing reports of pay rates tripling from before the pandemic.  Nearly 200 members of Congress have signed on in support.

Hospitals are crying foul over the high prices they have to pay traveling nurses during an escalating staff shortage. 

“When you see price increases that are two or three or more times what they were before the pandemic, it’s fair to at least investigate about whether or not these companies are price gouging,” AHA general counsel Mindy Hatton said on a media conference call.

Some legislators have proposed pay caps . A Pennsylvania lawmaker is even trying to cap travel pay in nursing homes; nurses report health systems are trying to set limits, too.

The corporate claims of financial stress are not helping strained staff relations.

“The ones who make the decisions, they don’t walk into a COVID patient’s room,” McNairy said. “They’re not risking their lives. They’re not away from home.”

McNairy has four kids and a husband in Mississippi, and she’s been away from her family for much of the pandemic.

Traveling nurses have always been paid more for their flexibility and experience. But hospitals say the going rate, which is often above $120 an hour , has ballooned beyond what they can afford. In the first quarter of this year, the Henry Ford Health System in Michigan plans to spend $50 million on what CEO Wright Lassiter calls “crisis labor.”

“That is the exorbitant labor cost related to the recent inflation in travel and contract nursing to supplement our staffing,” he said.

Of its 9,000 nursing jobs, Lassiter said 1,000 positions were open in January. Many nurses have left bedside roles during the pandemic to travel to COVID hotspots, given the much higher pay, creating a vicious cycle where their replacement will likely have to be a pricey traveler rather than a lower-paid permanent staffer.

Rural hospitals have had particular trouble holding on to their bedside staff, and not just nurses. West Tennessee Healthcare’s hospitals in the small communities of Camden and Bolivar lost half of their respiratory therapists who specialize in ventilating COVID patients to staffing agencies, according to CEO Ruby Kirby .

“We cannot compete with the salaries that they are offering to recruit additional staffing,” she said. 

CEOs have been careful to focus their criticism on staffing agencies — not nurses themselves — especially since many executives still make considerably more money. For example, Lassiter made $5.2 million in 2019 or roughly $100,000 a week, according to the most recent tax filings .

Hospital CEOs point out that traveling nurse agencies tack on an extra 30% or more for overhead and profits. Toby Malara, the American Staffing Association’s vice president of government relations, said an agency’s cut is paying for real expenses like recruiters and nurse training, not just profits.

And staffing firms are providing a way for nurses to work hard for three-month periods with high pay and then take a break.

“We know that if nurse staffing agencies weren’t around, we’ve heard from these nurses, that they might be out of the business altogether,” Malara said.

The American Nurses Association  predicts another 500,000 nurses will be retiring  this year and projects the need for 1.1 million new nurses to avoid a nursing shortage.

Nurses are organizing what’s being billed by some as a “million nurse march” in Washington, D.C. on May 12. McNairy said she’s hoping to fly across the country to be there so nurses can be heard.

“I can tell you this,” she said. “If they mess with our money, we’ll walk out.”

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Some nurses are getting paid more than doctors during a nationwide nurse shortage and another COVID surge

• Nurses are in high demand across the United States as COVID hospitalizations surge.
• In some places, nurses are making more than doctors due to lucrative travel nursing contracts.
• "We're seeing rates in excess of $200/hour, $225/hour," Northwell Health chief nurse exec Maureen White told Insider. 

For Tiffany, a nurse currently working in the Pacific Northwest who originally came from Western Pennsylvania, the prospect of travel nursing was a no-brainer.

"I was like, 'Cool! I can make money, pay my bills and see the country.'" she told Insider in a recent phone interview.

A key part of what enticed her away from a staff job at a Pittsburgh hospital back in 2013 was the promise of double or more her salary if she were to take on a traveling nurse contract. 

"I started at the ER, loved the ER, did it for a couple of years, and then started getting emails from companies that were saying like, 'Hey, we'll pay you twice as much as you're making,'" she said. Even better, Tiffany said, was that those jobs were always far from Pennsylvania, in places like California and Oregon. 

Hospitals across the country are enticing nurses with high-paying contracts as the industry faces staff shortages . Many nurses are experiencing burnout from the pandemic , but hospital systems were strained before COVID hit , and nurses say the past year and a half has only made things worse . 

Read more: Apple is scaling back a key health project that grew out of its care clinics, and some workers could lose their jobs

At her last contract job, Tiffany said she made $3,500 a week. That was before the pandemic, and things have only gotten more lucrative in the past year and change. "You could make $5,000, $7,000 per week easily," she said. 

"We're seeing rates in excess of $200 an hour, $225 an hour," Northwell Health chief nurse executive Maureen White, RN, told Insider. "Some places I hear as high as $250."

At those rates — approximately $10,000 a week — some nurses are making more than the doctors in the same hospital ER they're working in. Even in New York, America's highest-paying region for emergency physicians, the average weekly pay for ER doctors is about $6,400, according to ZipRecruiter data .

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Unlike hospital staff nurses, travel nurses work on temporary quarterly contracts of 13- or 14-week periods.

One quarter they might be outside of Seattle, another quarter they might be in Baltimore or Chattanooga, all depending on where the demand is at the moment.

With COVID hospitalization surging once again , hospitals are paying such huge contracts for travel nurses who can quickly relocate. This is especially true for nurses who work in hospital intensive care units (ICUs).

"It comes down to simple economics of supply and demand," White said. "It's unprecedented that we see, across the country and probably across the world, such a high demand for ICU nurses."

There are other, more banal factors as well.

"During the summertime months, all hospitals — Northwell included — we try to give as many of our employees [as possible] time off," White said.

There's also the backup of people dealing with more minor health issues that arose during the pandemic.

Read more: Ted Cruz has been doling out jobs — and taxpayer cash — to his cousins

"Even here in the Northeast, where we're not seeing right now that tremendous bump up in COVID patients," White said. "It's just people seeking healthcare more now and going in and saying, 'Oh, I probably should take care of this now.'"

Though the payout is massive, being a travel nurse adds another layer of complication to an already stressful and complicated job. And for some of the highest paying gigs, there are potentially much bigger institutional and/or regional issues that don't come through on the job application.

"There's a reason why people don't want to work there," Tiffany said. "Maybe the management sucks. Maybe you don't have the supplies you need. Maybe the patient populations really nasty or really sick. You're getting paid for your troubles."

Got a tip?  Contact Insider senior correspondent Ben Gilbert via email ( [email protected] ),  or Twitter DM ( @realbengilbert ). We can keep sources anonymous. Use a non-work device to reach out. PR pitches by email only, please.

Watch: Why NYC's largest emergency hospital is pretty much empty

• Main content

Top 15 Reasons Why Travel Nurses Are Paid So Much

Like many people, you may be wondering why are travel nurses paid so much? In the past few years, we all have heard reports of travel nurses getting paid excessive wages. However, the pandemic was raging, and healthcare systems were experiencing tremendous pressure to keep up with unprecedented patient overload. Hospitals were more than willing to pay generous wages to RNs courageous enough to travel across the country to staff covid hot spots. Now that the pandemic is over, travel nurses are still in demand. Travel nursing is a specialty that requires a special type of person. This gypsy caregiver is an adventurer, brave enough to often work outside her comfort zone and can acclimate quickly to new environments. Not every nurse possesses these impressive traits. These are RNs who are still a valuable commodity in our healthcare system. In this article, I break down the top 15 reasons why travel nurses are paid so much. Your eyes will be opened to the ongoing need for travel nurses, their value, and the many contributions these RNs make to the healthcare system. You should then better understand why travel nurses earn a plentiful wage.

DO TRAVEL NURSES ACTUALLY MAKE A LOT OF MONEY?

How much more do travel nurses make compared to non-travel nurses, why are travel nurses paid so much, reason #1: nursing shortage, reason #2: seasonal needs, reason #3: hard-to-fill positions, reason #4: remote areas of need, reason #5: flexibility, reason #6: adaptability.

• Unfamiliar locale • The ability to leave behind friends and family • Adapting to unfamiliar work sites • Working with new colleagues • Resettlement challenges

REASON #7: Cost-Savings

Reason #8: disaster relief, reason #9: large elderly population, reason #10: short-term leave relief, reason #11: decreased mandatory overtime, reason #12: stipends and bonuses add up, reason #13: reduced turn-over cost, reason #14: hard-to-fill specialty areas, reason #15: reduces costly benefits, will travel nurses continue to make a lot of money in the future, my final thoughts.

Travel Nurse Salary: How Much Do Travel Nurses Make?

• Travel Nurse Salary
• Salary Factors
• Salary by Specialty
• Highest Paying States
• Highest Paying Cities
• Top Paying Agencies
• How to Make More
• Related Careers
• Final Thoughts & Next Steps

How Much Do Travel Nurses Make?

The average annual travel nurse salary in the US is  $105,021 or $50/hr, according to  ZipRecruiter  as of May 2023. This is significantly higher than the average salary for registered nurses overall, which is $81,220 per year or $39.05 per hour per the BLS . 

>> Click here to see available high-paying travel nurse opportunities!

Travel nurse salaries range widely across the country, with the lowest earners making $40,000 and the highest earners making $155,500 annually!

If you are a Registered Nurse (RN) who has ever considered traveling the country and wants to know how much travel nurses earn, you’ve come to the right place! This travel nurse salary guide will explain everything you need to know about how much travel nurses can make. Including:

• Types of travel nurses who make the most money
• Travel nurse salaries by city and state incomes
• Top-paying travel nurse agencies
• How to increase your salary as a travel nurse

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Factors That Impact Travel Nurse Salaries

It is important to remember that travel nursing salary is dependent on several factors, including:

• Nursing specialty
• Full-time or part-time employment
• The shifts you work: day shift, night shift, mid-shifts, or weekends
• Bonus income

Also, travel nurses who work holidays often receive time-and-a-half or double-time pay, and in some cases, even more!

In addition, depending on the circumstances, travel nurses may also receive “crisis” pay due to needing to fill staffing urgently. If you have the desire and flexibility to move to another city or state quickly, a “crisis” assignment might be a great option for you.

Travel Nurse Salary by Specialty

What do travel nurses do that warrants their higher salaries? While flexibility is a significant factor, your travel nurse salary will also change depending on your nursing specialty.

Travel CRNA

Certified Registered Nurse Anesthetists (CRNAs) are the top-paid nursing specialty. The same holds true for CRNAs who take travel assignments as well. According to ZipRecruiter , CRNA travelers earn an average annual income of $194,352 or $93/hr. The highest earners make as much as $311,500!

Operating Room Travel Nurse

Operating Room (OR) travel nurses are in high demand at various locations around the country. ZipRecruiter found that operating room travel nurses earn an average annual income of $181,460 annually or $87/hr. The highest earners make as much as $286,000.

Emergency Room Travel Nurse

ZipRecruiter reports that ER travel nurses earn an average annual income of $83,503 annually or $40/hr. However, they add that the highest earners make as much as $171,500.

Intensive Care (ICU) Travel Nurse

According to ZipRecruiter , the average annual salary for ICU travel nurses is $143,416 annually or $69/hr. However, the highest earners make as much as $263,500.

Travel Nurse Practitioner

The average travel nurse practitioner salary is $140,086 annually or $67/hr, according to ZipRecruiter .  However, salary is often dependent on location and specialty. The highest-earning travel nurse practitioners make as much as $243,500.

Neonatal Intensive Care Unit (NICU) Travel Nurse

NICU travel nurses earn an average income of approximately $173,017 annually or $83/hr, according to ZipRecruiter . However, incomes across the country can range widely, with bottom earners making $56,000 and top earners bringing in $281,500.

Med-Surg Travel Nurse

ZipRecruiter reports that med-surg travel nurses in the US earn an average annual income of $118,997 or $57.21/hr. However, per-hour incomes can reach as high as $134.38, depending on your location and facility.

Telemetry Travel Nurse

ZipRecruiter states that telemetry Travel nurses earn an average annual income of $124,122 annually or $60/hr. However, top earners bring in as much as $174,500.

Top Paying States for Travel Nurses

Location can make a huge difference in salary as a travel nurse. ZipRecruiter reports that the states that offer the highest pay for travel nurses include:

• New York: $128,277 annually or $61.67/hr
• Arizona: $109,776 annually or $52.78/hr
• Wyoming: $109,765 annually or $52.77/hr
• Hawaii: $109,653 annually or $52.72/hr
• Tennessee: $107,708 annually or $51.78/hr
• Massachusetts: $107,000 annually or $51.44/hr
• New Jersey: $106,901 annually or $51.40/hr
• Washington: $106,086 annually or $51.00/hr
• West Virginia: $106,044 annually or $50.98/hr
• New Hampshire: $105,438 annually or $50.69/hr

Top Paying Cities for Travel Nurses

ZipRecruiter reports that the cities that offer the highest pay for travel nurses include:

• Barrow, AK: $137,200 annually or $65.96/hr
• San Jose, CA: $133,873 annually or $64.36/hr
• Oakland, CA: $132,042 annually or $63.48/hr
• Antioch, CA: $129,387 annually or $62.21/hr
• San Francisco Bay Area, CA: $128,781 annually or $61.91/hr
• Lebanon, NH: $128,674 annually or $61.86/hr
• New York, NY: $128,277 annually or $61.67/hr
• Hayward, CA: $127,865 annually or $61.47/hr
• Vallejo, CA: $127,791 annually or $61.44/hr 
• Seattle, WA: $127,691 annually or $61.39/hr

Top Paying Agencies for Travel Nurses

There are multiple top-paying travel nurse agencies across the US. It is important to remember that your pay package depends on several factors, and income may vary widely depending on location and the needs of the facility. When a healthcare facility has more urgent needs for travel nurses, the pay ranges typically increase.

>> Related: Travel Nurse Requirements

Aya Healthcare

Aya Healthcare is one of the largest travel nurse agencies in the country, and they offer a wide range of travel nurse opportunities for various nursing specialties and allied healthcare positions. 

Fusion Medical Staffing

Fusion is another large nurse travel agency with many opportunities for nurses to choose their top travel destinations. Their website reports that one of the biggest perks of working with them is that they offer dedicated contacts available every day and night, 24/7.

Axis Medical Staffing

Axis Medical Staffing has won awards for “Best Customer Service” by Verywell Health and “Top Travel Nursing Company 2022” by Travel Nursing Central. 

Travel Nurse Across America

The TNAA website boasts highly skilled recruiters, housing experts, and clinical and quality insurance that prepares their travel nurses for success. 

Gifted Healthcare

Gifted Healthcare is another large travel nursing agency that reports that they aim to open the door to the right opportunities for their clinicians. In fact, their website reports that 90% of travel nurses report that their assignments aligned perfectly with their skills and expectations. 

TotalMed Staffing

Headquartered in Appleton, WI, TotalMed Staffing has several other locations across the country, such as California, Illinois, Tennessee, and North Carolina. They serve various types of healthcare facilities across the country.

Ventura Medstaff

Ventura Medstaff prides itself on integrity. Their website makes it easy to find a match for various types of healthcare specialties in the right location and facility across the country.

Tailored Healthcare

The Tailored Healthcare website reports that travel nurses are rewarded professionally with high-paying travel assignments, Platinum Shield Benefits, and everything paid for upfront. In addition, the company celebrates its nurses year-round with praise, gifts, and best-in-class bonuses.

Titan Medical 

Titan Medical Group states that they help their clients “find your place.” They feature various jobs on their website daily and make it easier for clients to find their next travel assignment.  

MedPro Healthcare

Medpro Healthcare offers incredible benefits, including competitive compensation, travel reimbursement, health insurance, short and long-term disability, 401K, Continuing education, and even referral bonuses.

How to Increase Your Salary as a Travel Nurse

No matter where you live and work as a travel nurse, there are often opportunities to increase your salary.

Be Flexible With Your City and State

When you live and work in a city with a higher cost of living, you will also be compensated at a higher rate. For example, travel nurses who work in areas such as New York City, Los Angeles, San Francisco, or Seattle will earn significantly more income than travel nurses who choose to work in lower-cost-of-living areas. 

Consider Your Specialty(s)

If you have been cross-trained in more than one nursing specialty, you may want to see which specialties pay the most through your travel agency. For example, if you usually work as an ICU nurse, but a facility has crisis needs for telemetry nurses and will pay top dollar for that specialty, then you may want to consider accepting that travel assignment. After all, these are temporary assignments, and if you decide you don’t like them, you won’t have to stay for long.

Ask About Per Diem Daily Pay

Many nurses qualify for additional per diem pay for travel nurse housing , incidentals, and meals during their travel assignments. Talk to your travel agent to see if this applies to you.

Choose Shifts Wisely

Career and travel nurses are typically paid a few dollars more per hour for working less desirable shifts such as night shifts, mid shifts, and weekends.

In addition, travel nurses who work holidays often receive time and a half or double time pay!

Talk About Bonuses

Your travel agency will need to explain your bonus structure, as they can differ from agency to agency. However, here are a few of the different types of bonuses you may be eligible for as a travel RN:

• Agency bonus: Added pay from your travel agency
• Retention bonus: Your agency will often pay you a fee for referring your nurse and allied healthcare professional friends to their agency.
• Retention bonus: Agency-paid bonuses for nurses who continue to accept travel bonuses from the same agency.

Find Crisis or Strike Pay

Healthcare facilities in dire need of nursing staff during a public healthcare crisis, such as the COVID-19 pandemic or during a nursing strike, often will pay travel nurses significantly higher wages than during non-dire times. Talk to your travel agency to find out where the most significant staffing needs are. 

Consider Looking at Different Agencies

If you are ever disappointed with your travel pay or hear through the grapevine that other agencies pay significantly more, consider looking at different agencies. It is also wise to build relationships with other travel nurses so you can talk freely about what to expect at different agencies.

Consider Finding Your Own Housing

Many agencies offer a housing stipend and then secure your housing for you. However, if you find your own housing, you may be able to find something less expensive and pocket the rest of the money.

>> See more travel nurse salary tips in How to Make the Most Money as a Travel Nurse

Salaries of Related Nursing Careers vs. Travel Nursing

The following are salaries of non-traveling nursing specialties, according to ZipRecruiter:

• NICU Nurse : $136,592 annually or $66/hr
• Surgical Nurse: $120,699 annually, or $58/hr
• Postpartum Nurse: $108,952 annually or $52/hr
• Telemetry Nurse: $95,179 annually, or $46/hr
• ICU Nurse : $92,568 annually or $45/hr
• Emergency Room Nurse : $83,503 annually or $40/hr

Travel Nurse Salary: Final Thoughts & Next Steps

The high salaries alone are enough to make dozens of nurses excited to enter travel nursing. But the perks don't stop at pay - travel nurses get to see the world, interact with patients across cultures, and enjoy non-taxed travel stipends. If all that sounds enticing to you, check out our guide on how to become a travel nurse to start your dream career today!

Travel Nurse Salary FAQs

Do travel nurses get paid well.

• ZipRecruiter reports that as of May 2023, travel nurses in the US earned an average annual income of $105,021 or $50/hr. They also add that salaries range widely across the country, with the lowest earners making $40,000 and the highest earners making $155,500 annually! 

What is the highest travel nurse salary?

• CRNAs travelers are the top-paid travel registered nurse specialty.  According to ZipRecruiter, CRNA travelers earn an average annual income of $194,352 or $93/hr. The highest earners make as much as $311,500! 

Why are travel nurses paid so much?

• Travel nurses help to fill staffing gaps and often accept assignments in areas with severe or “crisis’” nursing shortages. For their travel flexibility and ability to work in sometimes hard-to-fill areas, they are typically paid a higher compensation.

Sarah Jividen , RN, BSN, is a trained neuro/trauma and emergency room nurse turned freelance healthcare writer/editor. As a journalism major, she combined her love for writing with her passion for high-level patient care. Sarah is the creator of Health Writing Solutions , LLC, specializing in writing about healthcare topics, including health journalism, education, and evidence-based health and wellness trends. She lives in Northern California with her husband and two children. 

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Hospitals Complain Nurses Making Too Much Money During Covid-19 Pandemic

Hospital groups are lobbying the white house to drive down wages for travel nurses..

The hospital industry is lobbying the White House to help drive down wages for health car e workers across the U.S. after many travel nurses saw a rise in wages during the covid-19 pandemic, according to a new report from the Wall Street Journal . And despite a critical shortage of nurses in the U.S., hospitals are doing everything they can to make sure they earn less money.

Suggested Reading

Travel nurses, which are used to temporarily supplement existing staff during times of crisis, have seen their wages rise from about $1,706 in December 2019 to $3,290 a week in December 2021, acco rding to the WSJ and Vivan Health.

Related Content

What can the U.S. government do to stop wages from rising? Hospitals argue that wages for travel nurses have gone up due to an influx of federal money from covid-19 relief funds and FEMA grants for natural disasters. But staffing agencies that connect nurses with hospital systems across the country argue that it’s simply a matter of supply and demand.

A study of nurses by the American Association of Critical-Care Nurses in late 2021 found that 66% were thinking about leaving the health care industry since the pandemic started due to their poor experiences . And a whopping 92% said the pandemic had depleted nurses and will make them leave their jobs much sooner than they planned.

Health care workers have been inundated with extreme conditions since the start of the pandemic in early 2020. Nurses have been surrounded by death, with over 908 ,000 Americans dying of the disease since early 2020. A nd even when people with covid-19 survive, they can struggle with long term illness that must also be managed—often with the help of nurses, of course.

To make matters worse, nurses have been forced to improvise on resources (who can forget the garbage bags nurses had to wear instead of PPE ?) and have faced verbal and sometimes physical abuse from the family members of patients who believe covid-19 isn’t even real.

But U.S. lawmakers are notoriously in league with the health care industry, and many are conspiring to lower wages for nurses. The WSJ notes that almost 200 of the U.S. House’s 435 members, both Democrats and Republicans, are working to depress pay for nurses:

Almost 200 House lawmakers led by Reps. Peter Welch (D., Vt.) and Morgan Griffith (R., Va.) on Jan. 25 asked the White House to investigate the run-up in wages that staffing agencies pay contract nurses. Trade groups the American Hospital Association, the American Health Care Association and National Center for Assisted Living wrote recently to the White House that staffing firms are exploiting the pandemic by charging exorbitant prices.

Private hospitals apparently love supply and demand until it causes nurses to make more money. Rep. Welch, it should be noted, counts the health care industry as one of his largely donors, according to the transparency group Open Secrets . The same goes for Rep. Griffith , and plenty of other legislators currently trying to make sure America’s “heroes” get a paycut.

One company mentioned by the WSJ, SnapNurse , allows travel nurses to register and be notified when jobs are available. And, again, it’s all a matter of supply and demand. In Alaska, as just one example, traveling nurses can make almost $5,000 per week, largely because it’s hard to get people to work in such a remote, cold climate during the winter.

The U.S. reported 199,075 new cases of covid-19 on Tuesday and 3,406 new deaths from the disease. At least 100,450 people with covid-19 are currently being treated in the hospital, with 19,085 in intensive care.

And if you’re a nurse, try to get paid well now. Powerful groups are working to make sure you’re paid less than you’re worth in the very near future.

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Nurses can earn much more as traveling nurses. but the job comes at another cost.

Blake Farmer

A nurse who left her hospital job for much higher wages as a traveling nurse found the lifestyle hard on her family. But permanent jobs but those don't pay much better than they did pre-pandemic.

Copyright © 2022 NPR. All rights reserved. Visit our website terms of use and permissions pages at www.npr.org for further information.

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How Much Do Travel Nurses Make In A Year? | Salary 2023

Travel nursing has been all the rage for the last few years. Travel nursing positions come with plenty of perks, such as high travel nurse salaries, incentives like sign-on bonuses, and the opportunity to work in glamorous places like Hawaii and Florida.

But, do travel nurses really make more money? The answer is yes…usually. However, the exact amount of money you can make as a travel nurse really depends on a variety of different factors.

Below is a breakdown of a travel nurse’s salary and why travel nurses tend to get paid more than nurses in traditional roles.

Find available, high-paying travel nurse opportunities.

Do Travel Nurses Make More Money?

In general, travel nurses have the opportunity to make more money than staff nurses for two main reasons:

1. High need = higher pay

Travel nurse staffing agencies work specifically with hospitals, clinics, and other healthcare facilities that have a high demand for nurses, which means they are willing to pay more to reach adequate staffing levels or to cover a known leave of absence.

2. Additional monetary incentives.

Unlike regular staff nurses, travel nurses are paid a “total pay package” that includes an hourly base wage pay plus additional monetary incentives, like the following:

• Sign-on or referral bonuses
• Travel reimbursements
• Stipends for housing
• Food, mileage, or job-related expenses

Because these extra stipends are classified as reimbursements and not income, they’re non-taxable, so a travel nurse can bring home a higher total pay when compared to a staff nurse, who pays taxes on all of the income they bring home.

How Much Do Travel Nurses Make?

The average salary for travel nurses in 2023 was $126,384, according to Indeed.com . That is significantly higher than the average salary for staff nurses of $93,042 per year, according to the Bureau of Labor Statistics (BLS).

The exact salary you can expect to make as a travel nurse will vary widely based on where you choose to work, the type of nursing position it is, and the length of the contract.

For example, you may make more in a month as a travel nurse compared to a staff nurse, but if you only work one- or two-month-long assignments, your annual pay will be lower. However, if you take several assignments in a 12-month period, then you could make significantly more in one year than you could as a staff nurse.

Your total travel nursing pay package will look different than that of a staff nurse because it’s made up of your “base wage” pay — the hourly rate you earn for your nursing duties — and additional stipends, which are classified as non-taxable reimbursements and not considered income. As an example, a standard total travel nurse pay package could look something like this:

*Assumes $20 per hour at 40 hours per week, minus taxes

You should consult your own certified financial planner if you have concerns before you start travel nursing. It may help you evaluate if a travel nurse pay package is right for you based on your overall financial goals.

Find travel nursing assignments by speaking with a recruiter today!

Do Travel Nurses Get Benefits?

Some travel nurse staffing agencies also offer travel nurses additional benefits, such as retirement options and health, dental, vision, and life insurance. Keep in mind, retirement options that include a 401(k) may not be the most effective option if your taxable income is already low. It may make more sense to invest in a Roth IRA or other retirement account. But again, consult with your tax professional before making any major decisions.

Most travel nursing companies also require that you work a certain number of months before the 401(k) becomes available for travelers.

Why? One of the main benefits of a 401(k) is that it allows you to contribute your income before it’s taxed, but a large portion of most travel nurses’ total pay packages is non-taxable. Contributing to a 401(k) can decrease a travel nurse’s overall taxable income considerably and may lead to issues down the road — if they need to qualify for a home loan, for example.

Highest Paying Locations for Registered Nurses

Where you choose to work as a travel nurse also plays a large role in how much you will make. Certain cities and states offer higher pay because they have such a high demand for nurses, while other areas pay more based on the time of year.

For example, if you’re willing to travel to Alaska in the winter, you have the opportunity to make more money than if you worked in Hawaii in the winter months. Travel nurses who are willing to relocate to “less popular” areas throughout the year stand to increase the amount of overall pay they can make over the course of the entire year.

You could also seek out assignments in the highest-paying states and cities for travel nurses . For example, based on data from the Bureau of Labor Statistics , the top 10 highest-paying cities for RNs (not specifically travel nurses) currently are:

Source: ZipRecruiter

The Top Highest Paying States for RNs in 2023 – based on all specialties

• District of Columbia

Source: BLS

Keep in mind that the Bureau of Labor Statistics data lists average salaries for RNs, so the potential for travel nurses specifically in those areas is even higher. However, you also have to consider the cost of living in those areas and if the stipends you’ll receive for housing, food, and other expenses will adequately cover those costs.

Read more: Best Cities for Travel Nurses

A Note on Nursing Specialties

Working a travel nursing assignment in a high-paying state or city is one way to increase your take-home salary. However, you can also increase your pay as a travel nurse by working in an in-demand specialty.

The average travel nurse’s salary does vary based on specialty. For example, travel nurses who work in the following in-demand specialties have the opportunity to make more pay (or negotiate for higher pay). Did you hear that? You can negotiate!

Some of those specialties include:

• Critical Care
• Labor and delivery
• Orthopedics

If you have experience in an in-demand area, you should highlight that on your travel nursing application, as well as bring it to the attention of the travel nurse recruiter to maximize your pay.

Additionally, you may be able to make even more money if you seek out specialty certification in your area on your own prior to signing with a travel nursing agency.

Having a nurse who is “ready to go” in a specialty area may be more lucrative to a staffing agency than a nurse who is simply willing to be trained, but not yet certified.

Travel Nursing Salary: Beyond a Paycheck

Travel nursing can be a profitable way to boost your savings and overall take-home pay. But the benefits don’t stop with just your paycheck. Travel nursing has so many other perks:

• Expand your resume
• Gain valuable hands-on nursing experience
• Learn skills on the job
• Increase your confidence
• Find hospitals or coworkers you may want to work with as a staff nurse in the future
• And ultimately, advance your career

As a travel nurse, you’ll have the opportunity to work in fields you may not have access to close to home or receive additional training to further your nursing skills as well. Also, because travel nursing is flexible and can accommodate both short and long-term positions, many nurses can try temporary nursing assignments whether they’re single, partnered, married, child-free, or have a family.

And, of course, travel nursing is a great way to experience other parts of the country to live in, see, and explore.

RNs can earn up to $2,300 per week as travel nurses. Speak to a recruiter today!

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Budgeting, Earning, and Saving Tips for Travel Nurses

by Trusted Nurse Staffing | Nov 12, 2022 | News

You’re trying to figure out how to save money while on the road as a travel nurse.

Paying for your living expenses — plus your travel costs and your bills back home — it’s all adding up quickly.

You wonder how you can better manage your money, and you’re looking for tips.

With our step-by-step guide, you will learn the best budgeting, earning, and savings tips for travel nurses on the road.

Table of Contents

7 budget tips for travel nurses.

• 5 Cost-Minimizing Tips To Help Travel Nurses Stay on Budget 

3 Ways To Earn Extra Income as a Travel Nurse

Let trusted nurse staffing help you find the assignment with the earning potential you desire.

Budgeting tips for travel nurses include creating a budget, tracking spending, and looking for ways to reduce expenses. 

Keep reading to receive practical tips for saving money while on your travel nursing assignments.

Do you already have a budget in place for your next nursing assignment? 

If so, let Trusted Nurse Staffing help you find your dream assignment as a travel nurse. 

Click below to create your free profile. 

#1: Establish a Comprehensive Budget That Includes Savings

One of the best ways to save money is to be aware of where your money is going. 

A comprehensive budget will allocate a category for every purchase you make, which may include expenses for:

• Entertainment; and
• Transportation costs

Remember to make your savings a priority in your budget, which can give you some “cushion” as you transition to your next assignment or have extended time off of work.

From there, you can make adjustments to ensure your spending aligns with your overall need and lifestyle goals.

#2: Set Clear and Measurable Spending and Saving Goals

Setting measurable spending and saving goals is a vital part of any budget, and it’s especially important for travel nurses. Without a clear goal in mind, it’s easy to overspend on unnecessary things.

Considering the following format for setting clear and measurable goals for your spending:

• I will only spend $X on restaurants this month.
• I will only spend $X on shopping this month.
• I will only spend $X on entertainment this month.

Your saving goals might include:

• I will save $X from each paycheck.
• I will put $X into my savings account each week.
• I will save 10% of my income each month.

Whatever your goals are, make sure they are clear and specific so that you can easily track your progress and make adjustments as needed.

#3: Track Expenses, Evaluate Spending, and Make Adjustments

Before you can budget, be aware of your spending and evaluate your expenses periodically. 

Tracking your expenses is a great way to get started. You can then make adjustments as needed. 

Sometimes you don’t realize where your money is going. 

For example, you may find that you carelessly spend over $300 for snacks at the vending machine at work each month.

By tracking your expenses, evaluating your spending patterns, and making adjustments as needed, you can ensure you are staying on track with your budget and reaching your financial goals.

#4: Pay Off Debt

One of the best ways to save money as a travel nurse is to pay off any debt you may have while on assignment. 

Not only will this free up more of your income to save or spend as you please, but it will also help you avoid accruing any new debt while on the job.

If you have …

• Student loans
• Credit card debt; or
• Other types of debt

… consider using some of your savings to pay it off so that after your next travel nurse assignment, you can take that well-earned vacation.

#5: Plan Ahead for Time Off Between Assignments

After a long and rewarding assignment, most travel nurses look forward to some well-deserved time off. 

But if you’re not careful, this time off can be more expensive than you think.

Consider these three tips to help you plan ahead and save money while you’re between assignments:

• Make sure you have enough money saved to cover your expenses for the entire time you’ll be off between assignments.
• Try to schedule your time off so it coincides with slower times of the year for travel nursing and find more affordable housing and transportation options.
• Get creative with your housing options and consider staying with friends or family, renting an RV or camper, or even house-sitting for someone going out of town.

It’s nice to take some time to chill and refresh before the next one — but if you don’t plan for it, it might be difficult to afford. 

#6: Choose an Assignment That Allows You To Stay on Budget

When you’re a travel nurse, it’s important to choose an assignment that allows you to stay on budget. 

For example, if you are considering Hawaii for your next assignment, you need to be sure that your salary will compensate for the higher cost of living .  

To help you choose an assignment that allows you to stay on budget, consider these five tips:

• Research the cost of living in your assignment location.
• Make sure your compensation package covers your basic expenses.
• Consider signing a longer-term contract to get a discount on your housing.
• Use your per diem to cover incidentals like meals and entertainment.
• Stay in budget-friendly accommodations like hostels or vacation rentals.

Following these tips will help you stay on budget and enjoy your travel nursing adventures.

#7: Take Advantage of Your Agency’s Benefits

Take advantage of all the benefits your agency offers.

Your agency should offer a comprehensive benefits package that includes:

• Medical, dental, and vision coverage
• Referral bonuses ; and
• Travel nursing stipends 

It’s important to research these and other benefits before you accept a position, as different agencies offer different levels of coverage. 

You should also find out if your agency offers any other perks, such as:

• Pet insurance
• Roadside assistance; or
• Discounted travel rates

Are you looking for a travel nursing agency?

Check out Trusted Nurse Staffing and let us help you find your next assignment with the earning potential and benefits you desire.

5 Cost-Minimizing Tips To Help Travel Nurses Stay on Budget

#1: look for coupons or groupon deals.

When you’re on the road for several months at a time, look for deals and coupons. 

Many stores offer deals to customers who sign up for their mailing lists. 

Others will have special sales or coupons available online or in-store. 

Groupon is also a great source for finding exclusive local deals, such as:

• Restaurants
• Events; and
• Fitness centers

#2: Make Your Own Meals and Coffee

One of the quickest ways to deplete your travel nursing budget is to eat out for every meal and make $4 Starbucks runs every morning.

While it’s fine to enjoy the occasional restaurant meal or specialty coffee, you’ll save a lot of money in the long run if you cook most of your meals and make your own coffee.

If you’re not into making your own coffee, consider buying a reusable filter and using grounds from your local coffee shop instead of single-use pods.

If cooking meals from scratch sounds like too much work, consider preparing several meals in advance and reheating them throughout the week. 

There are tons of great recipes online for healthy and budget-friendly meals that can be easily prepped in advance.

#3: Use the Agency Stipend

Are you wondering how to best use your stipend? 

It’s important to use the stipend for what it is intended — after all, it is there to help cover the cost of your housing and other living expenses while you are on assignment.

However, that doesn’t mean that you can’t use the extra money for other things.

Here are some tips for how to use your stipend:

• Cover the cost of your housing and other living expenses as your first priority.
• Save some money to have a savings cushion for when unexpected expenses may come up.
• Use the extra money for fun activities or souvenirs. When you are only in a place for a few weeks or months, it can be easy to blow all of your money on nights out or activities. 

And remember, there is nothing wrong with treating yourself.

Make sure you are also budgeting for souvenirs or other things you want to take home with you from your experience.

#4: Travel With Friends

One of the best ways to save money while travel nursing is to find a group of travel nurse friends and travel together. 

When you travel with a group, you can share living costs on things like:

• Transportation
• Groceries; and
• Other incidentals

If you are on a tight budget, traveling with a group can be a great way to save money.

#5: Be Creative With Transportation

There are countless ways to save money on transportation costs while travel nursing. 

If the hospital is in a city with public transportation, take advantage of it. Many times, a travel nurse can get a discount on public transportation costs by showing their ID badge. 

If the location isn’t ideal for public transportation or if you prefer to get some exercise, consider biking or walking to work. 

And of course, there are always ride-sharing programs like Uber and Lyft.

#1: Take on Per Diem Work

Per diem work is a great way to boost your earnings as a travel nurse. 

By picking up a few extra shifts here and there, you can really pad your bank account. 

Just be sure to factor in the cost of transportation to and from the hospital.

#2: Work the Night Shift

If you’re looking to maximize your earnings as a travel nurse, working the night shift is a great way to do it. Working the night shift can add up to 50% to your hourly rate.

Of course, working the night shift can be tough. It can be difficult adjusting to sleeping during the day, and you may miss out on some of the social aspects of travel nursing.

But if you’re looking to boost your earnings, it’s worth considering.

#3: Earn a Specialty Certification or Advanced Degree

There are many ways to qualify for higher-paying travel nursing jobs . 

One way is to earn a specialty certification or advanced degree in a particular area of nursing. 

For example, nurses with a certification in intensive care or emergency room nursing can command higher salaries than their non-specialized counterparts.

While it may take some time and effort to pursue these higher levels of education, doing so can pay off handsomely in the long run for both salary and job satisfaction.

At Trusted Nurse Staffing , we understand that one of the biggest factors in deciding whether to accept a travel nursing assignment is the pay. 

You want to find an assignment that pays well, but you also want to be sure you can manage your finances and make the most of your earnings.

Whether you’re a seasoned travel nurse or just starting out, finding the right assignment can be a challenge. 

You want an assignment that meets your needs of … 

• Salary; and 

… but you may not know where to start. 

That’s where Trusted Nurse Staffing comes in. 

Our professional team can help you find the right assignment, with the earning potential you desire. 

We can also offer guidance and support throughout your career.

Click below to contact us today.

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Election latest: Nigel Farage 'playing into hands of Putin', Rishi Sunak says - as Labour condemn 'Tory s***show'

Reform UK leader Nigel Farage is under fire after reiterating he blames the West and NATO for the Russian invasion of Ukraine. Meanwhile, analysis for Sky News shows his party's tax plans disproportionately benefit those on higher incomes.

Saturday 22 June 2024 18:10, UK

• General Election 2024

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• Farage under fire for 'disgraceful' comments on Ukraine war
• Sunak says Reform UK leader's comments 'completely wrong'
• Labour: 'Shocking' to see Farage 'get down on his knees and kiss Putin's boots'
• Jon Craig:  Has the Reform UK leader made his first mistake of the election campaign?
• Reform UK's tax plans disproportionately benefit high earners, analysis shows
• Labour unveil 'Tory s***show' attack ad
• Live reporting by Ben Bloch

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Our daily politics show  Politics Hub  will be live on Sky News from 7pm with our  political correspondent  Ali Fortescue  hosting this evening.

The fast-paced programme dissects the inner workings of Westminster, with interviews, insights, and analysis - bringing you, the audience, into the corridors of power.

Joining Ali tonight:

• Tom Tugendhat, security minister
• Scarlett Maguire, director at JL Partners polls

And on her panel are:

• Ava Santina Evans, political correspondent at PoliticsJOE
• Charlie Rowley, former special adviser to Michael Gove

Watch live on Sky News, in the stream at the top of this page, and follow live updates here in the Politics Hub.

Watch  Politics Hub  from 7pm every night during the election campaign on Sky channel 501, Virgin channel 602, Freeview channel 233, on the  Sky News website  and  app  or on  YouTube .

Our live poll tracker collates the results of opinion surveys carried out by all the main polling organisations - and allows you to see how the political parties are performing in the run-up to the general election.

It currently shows a drop in support in recent days for Labour and the Tories - with a jump for Reform and the Liberal Democrats.

Read more about the tracker here .

By Gurpreet Narwan , political correspondent

Reform UK bills itself as the party "for the left behind" but its flagship tax policy disproportionately benefits those on higher incomes, analysis for Sky News shows.

Nigel Farage hailed the plan to raise the threshold at which workers start paying tax to from £12,571 to £20,000, saying it would lift millions of low-paid workers out of paying tax altogether.

However, Reform's plan to raise the higher rate threshold from £50,271 to £70,000 would amount to a tax cut worth almost £6,000 for the top 10% of earners, vastly overshadowing the benefit to the lowest earners.

The top 10% of households, by disposable income, have £3,000 a month to spend after housing costs, council tax and direct taxes. A couple in this category would have £5,290 to spend.

These people would gain almost £5,983 in disposable income each year as a result of the changes.

The bottom 10% of households have less than £693 to spend on things such as heating and food each month. The figure rises to £1,195 for a couple. These households would gain an extra £221 per year.

Despite the vast discrepancy, Reform UK has repeatedly framed this as a policy for the lowest paid.

At the party's manifesto launch in South Wales, Mr Farage said: "I think the most innovative policy that we've put out in here is to raise the level at which people start paying tax to £20,000 a year.

"Why? Well, number one, it would take seven million people out of the tax system altogether, a devilishly complicated tax system. That would be a good thing, of course, for those on low pay."

Read the full analysis here:

Nigel Farage has doubled down on his comments about the Ukraine war, saying he was "telling the truth" when he said the West "provoked" the Russian invasion.

In an opinion piece for  The Telegraph , the Reform UK leader insisted he was not a supporter of Vladimir Putin and called the Russian president's actions "entirely wrong".

But he claimed he saw the conflict coming "a decade ago" and said the West has spent the last 10 years "playing into Putin's hands".

Mr Farage said he warned in 2014 that a war would emerge and has "made clear on multiple occasions since then, if you poke the Russian bear with a stick, don’t be surprised if he responds". 

He said the West had failed to "tackle Putin's mix of paranoia and assertiveness" and suggested it had pursued a dangerous foreign policy.

"There is no easy solution to the war. But facing up to the truth about the causes and consequences must be a start," he said.

Rishi Sunak said Mr Farage's earlier comments were "completely wrong", while Sir Keir Starmer branded the remarks "disgraceful".

Scottish First Minister John Swinney has also weighed in, calling the Reform leader a "traitor to the interests of the people of these islands".

By Rob Powell , political correspondent

The architect of the government's delayed reforms to social care has told Sky News politicians need to "grow up" and tackle the crisis in the sector.

Amid a bitter election row over public spending, Sir Andrew Dilnot said he believed the two main parties were reluctant to discuss care reform for fear of being accused of plotting future tax hikes.

Sir Andrew - whose 2011 report laid out several key measures adopted by the government - described social care as the "biggest risk that isn't managed" that the country faces.

He said: "Four out of five people are going to need  social care  before they die, we should grow up and face it."

"I think politicians are reluctant to talk about it firstly because they're worried about anything that means an increase in public spending and therefore possible taxation," he added.

You can read more below:

By Tom Cheshire , online campaign correspondent 

If you want a good idea of what matters to each party - its deepest desires, its darkest fears - look at where it's spending money.

What it shows is a story of Labour spending big and spending everywhere, as it pursues a plausible supermajority, while the Conservatives retreat to fight for some of their heartland constituencies, and spend much less. 

It shows the current state of play for all parties across the country. The map shows which is the biggest spender in each constituency - which parts of the country they're fighting to win, or not to lose.

The map was created by Who Targets Me (WTM), which tracks digital political advertising and has partnered with Sky News as part of our online campaign team.

"Our map of advertising activity shows where the parties have targeted their Facebook and Instagram ads in the last week," Sam Jeffers, executive director of WTM, says.

From first past the post to voter ID, here's everything you need to know about the general election in less than five minutes.

 The Conservative Party is seen as "tawdry", Ruth Davidson has said, as two of its candidates are being investigated over alleged bets placed on the election date.

The Gambling Commission is looking into two Tory candidates over alleged wagers on the date of the 4 July election.

An industry source has told Sky News that "more names" are being looked into, but police are so far "not involved".

Speaking on the  Electoral Dysfunction podcast with Sky News political editor Beth Rigby, and former broadcaster and presenter Carol Vorderman, the former leader of the Scottish Tories waded into the fallout of the alleged betting scandal.

"What an absolute shit show. Firstly, I mean, how tawdry is it?" she said.

She described it as akin to "insider trading" and criticised Rishi Sunak's response, saying he had repeatedly failed to get out in front and take control of events.

👉 Click here to follow Electoral Dysfunction wherever you get your podcasts  👈

By Laura Bundock , news correspondent

The election might seem like a two-horse race, but other parties are jockeying for votes too.

We put their manifestos to the Sky News YouGov Voters Panel.

Representing different political backgrounds and more than 40 different constituencies, they pored over the promises and policies.

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